Prediction of Recurrence After Endoscopic Treatment for Esophageal Varices: With Special Reference to Esophageal Variceal Pressure

Background: We investigated the factors influencing esophageal variceal recurrence after endoscopic treatment on the basis of 25 variceal patients who were measured for esophageal variceal pressure, which had been reported to have a close relationship to variceal rupture. Method: Six patients (24.0%) showed variceal recurrence during follow‐up periods of up to 60 months. Clinical, biochemical, endoscopic and portal hemodynamic parameters were analyzed by univariate analysis in order to determine variceal recurrence. Results: The cumulative risk of variceal recurrence was greater in patients with F3 varices (P = 0.027), and esophageal variceal pressure (EVP) ≥ 15 mmHg (P = 0.021). It was not significantly related to any clinical, biochemical parameter. Large portosystemic collaterals, which were not concerned with esophageal varices, were demonstrated in five patients who had never showed variceal recurrence; all of their EVP were under 15 mmHg. Conclusion: It is suggested that the form of varices and EVP, which may reflect a part of portal hemodynamics, are the most reliable factors for predicting variceal recurrence.